Provider Demographics
NPI:1427262161
Name:BALDWIN, AARON (DMD, MD)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:
Last Name:BALDWIN
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MCAULEY CT
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6312
Mailing Address - Country:US
Mailing Address - Phone:501-623-4485
Mailing Address - Fax:501-623-4480
Practice Address - Street 1:200 MCAULEY CT
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6312
Practice Address - Country:US
Practice Address - Phone:501-623-4485
Practice Address - Fax:501-623-4480
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY8741223S0112X
KY44995204E00000X
AR39971223S0112X
ARE8873204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100004530Medicaid